CATEGORY 1
CATEGORY 2
CATEGORY 3
CATEGORY 4
CATEGORY 5
100
The nurse is providing discharge teaching for the client with leukemia. The client should be told to avoid:
- A. Using oil- or cream-based soaps
- B. Flossing between the teeth
- C. The intake of salt
- D. Using an electric razor
Correct Answer: B. Flossing between the teeth
The client who is immune-suppressed and has bone marrow suppression should be taught not to floss his teeth because platelets are decreased.
100
The toddler is admitted with a cardiac anomaly. The nurse is aware that the infant with a ventricular septal defect will:
- A. Tire easily
- B. Grow normally
- C. Need more calories
- D. Be more susceptible to viral infections
Correct Answer: A. Tire easily
The toddler with a ventricular septal defect will tire easily. The hole (defect) occurs in the wall (septum) that separates the heart’s lower chambers (ventricles) and allows blood to pass from the left to the right side of the heart. The oxygen-rich blood then gets pumped back to the lungs instead of out to the body, causing the heart to work harder.
100
The nurse has a preop order to administer valium (Diazepam) 10mg and phenergan (Promethazine) 25mg. The correct method of administering these medications is to:
- A. Administer the medications together in one syringe
- B. Administer the medication separately
- C. Administer the Valium, wait 5 minutes, and then inject the Phenergan
- D. Question the order because they cannot be given at the same time
Correct Answer: B. Administer the medication separately
Medications should not be mixed in one syringe unless indicated by the physician.
100
What’s the first intervention for a patient experiencing chest pain and a p02 of 89%?
- A. Administer morphine
- B. Administer oxygen
- C. Administer sublingual nitroglycerin
- D. Obtain an electrocardiogram (ECC)
Correct Answer: B. Administer oxygen
Administering supplemental oxygen to the patient is the first priority. Administer oxygen to increase SpO2 to greater than 90% to help prevent further cardiac damage.
100
A pregnant woman arrives at the emergency department (ED) with abruptio placentae at 34 weeks’ gestation. She’s at risk for which of the following blood dyscrasias?
- A. Heparin-associated thrombosis and thrombocytopenia (HATT)
- B. Idiopathic thrombocytopenic purpura (ITP)
- C. Thrombocytopenia
- D. Disseminated intravascular coagulation (DIC)
Correct Answer: D. Disseminated intravascular coagulation (DIC)
Abruptio placentae is a cause of DIC because it activates the clotting cascade after hemorrhage.
200
The nurse is changing the ties of the client with a tracheostomy. The safest method of changing the tracheostomy ties is to:
- A. Apply the new tie before removing the old one.
- B. Have a helper present.
- C. Hold the tracheostomy with the nondominant hand while removing the old tie.
- D. Ask the doctor to suture the tracheostomy in place.
Correct Answer: A. Apply the new tie before removing the old one.
Leaving the old ties in place while securing the clean ties prevents inadvertent dislodging of the tracheostomy tube.
200
The nurse is monitoring a client with a history of stillborn infants. The nurse is aware that a nonstress test can be ordered for this client to:
- A. Determine lung maturity
- B. Measure the fetal activity
- C. Show the effect of contractions on fetal heart rate
- D. Measure the wellbeing of the fetus
Correct Answer: B. Measure the fetal activity
A nonstress test determines periodic movement of the fetus.
200
A client with frequent urinary tract infections asks the nurse how she can prevent the recurrence. The nurse should teach the client to:
- A. Douche after intercourse
- B. Void every 3 hours
- C. Obtain a urinalysis monthly
- D. Wipe from back to front after voiding
Correct Answer: B. Void every 3 hours
Voiding every 3 hours prevents stagnant urine from collecting in the bladder, where bacteria can grow.
200
Which of the following signs and symptoms usually signifies rapid expansion and impending rupture of an abdominal aortic aneurysm?
- A. Abdominal pain
- B. Absent pedal pulses
- C. Chest pain
- D. Lower back pain
Correct Answer: D. Lower back pain
Lower back pain results from the expansion of an aneurysm. The expansion applies pressure in the abdomen, and the pain is referred to the lower back.
200
A 16-year-old patient involved in a motor vehicle accident arrives in the ED unconscious and severely hypotensive. He’s suspected to have several fractures of his pelvis and legs. Which of the following parenteral fluids is the best choice for his current condition?
- A. Packed red blood cells
- B. 0.9% sodium chloride solution
- C. Lactated Ringer’s solution
- D. Fresh frozen plasma
Correct Answer: A. Packed red blood cells
In a trauma situation, the first blood product given is unmatched (O negative) packed red blood cells.
300
The nurse is monitoring a client following a lung resection. The hourly output from the chest tube was 300mL. The nurse should give priority to:
- A. Turning the client to the left side
- B. Milking the tube to ensure patency
- C. Slowing the intravenous infusion
- D. Notifying the physician
Correct Answer: D. Notifying the physician
The output of 300 mL is indicative of hemorrhage and should be reported immediately.
300
The nurse is evaluating the client who was admitted 8 hours ago for induction of labor. The following graph is noted on the monitor. Which action should be taken first by the nurse?
- A. Instruct the client to push
- B. Perform a vaginal exam
- C. Turn off the Pitocin infusion
- D. Place the client in a semi-Fowler’s position
Correct Answer: C. Turn off the Pitocin infusion
The monitor indicates variable decelerations caused by cord compression. If Pitocin is infusing, the nurse should turn off the Pitocin.
300
Which task should be assigned to the nursing assistant?
- A. Placing the client in seclusion
- B. Emptying the Foley catheter of the preeclamptic client
- C. Feeding the client with dementia
- D. Ambulating the client with a fractured hip
Correct Answer: C. Feeding the client with dementia
Of these clients, the one who should be assigned to the care of the nursing assistant is feeding the client with dementia.
300
In which of the following types of cardiomyopathy does cardiac output remain normal?
- A. Obliterative
- B. Restrictive
- C. Dilated
- D. Hypertrophic
Correct Answer: D. Hypertrophic
Hypertrophic cardiomyopathy (HCM) is a condition in which there is severe ventricular hypertrophy and poor diastolic filling. It is an autosomal dominant condition wherein the heart muscles asymmetrically increase in size and mass along the septum. The increase in the thickness of heart muscles reduces the size of the cavities of the ventricles, causing them to take a longer time to relax after systole. Cardiac output isn’t affected by hypertrophic cardiomyopathy because the ventricle’s size remains relatively unchanged.
300
Corticosteroids are potent suppressors of the body’s inflammatory response. Which of the following conditions or actions do they suppress?
- A. Cushing syndrome
- B. Pain receptors
- C. Immune response
- D. Neural transmission
Correct Answer: C. Immune response
Corticosteroids suppress eosinophils, lymphocytes, and natural killer cells, inhibiting the natural inflammatory process in an infected or injured part of the body. This helps resolve inflammation, stabilizes lysosomal membranes, decreases capillary permeability, and depresses phagocytosis of tissues by white blood cells, thus blocking the release of more inflammatory materials.
400
The infant is admitted to the unit with tetralogy of fallot. The nurse would anticipate an order for which medication?
- A. Digoxin
- B. Epinephrine
- C. Aminophylline
- D. Atropine
Correct Answer: A. Digoxin
The infant with Tetralogy of Fallot involves four heart defects: A large ventricular septal defect (VSD), Pulmonary stenosis, Right ventricular hypertrophy and, An overriding aorta. He will be treated with digoxin to slow and strengthen the heart.
400
The nurse notes the following on the ECG monitor. The nurse would evaluate the cardiac arrhythmia as:
- A. Atrial flutter
- B. A sinus rhythm
- C. Ventricular tachycardia
- D. Atrial fibrillation
Correct Answer: C. Ventricular tachycardia
The graph indicates ventricular tachycardia.
400
The client has recently returned from having a thyroidectomy. The nurse should keep which of the following at the bedside?
- A. A tracheostomy set
- B. A padded tongue blade
- C. An endotracheal tube
- D. An airway
Correct Answer: A. A tracheotomy set
The client who has recently had a thyroidectomy is at risk for tracheal edema.
400
Which of the following interventions should be your first priority when treating a patient experiencing chest pain while walking?
- A. Have the patient sit down.
- B. Get the patient back to bed.
- C. Obtain an ECG.
- D. Administer sublingual nitroglycerin.
Correct Answer: A. Have the patient sit down.
The initial priority is to decrease oxygen consumption by sitting the patient down.
400
A patient infected with human immunodeficiency virus (HIV) begins zidovudine therapy. Which of the following statements best describes this drug’s action?
- A. It stimulates the immune system.
- B. It destroys the outer wall of the virus and kills it.
- C. It interferes with viral replication
- D. It promotes excretion of viral antibodies.
Correct Answer: C. It interferes with viral replication.
Zidovudine inhibits DNA synthesis in HIV, thus interfering with viral replication. The drug doesn’t destroy the viral wall, stimulate the immune system, or promote HIV antibody excretion.
500
The nurse is educating the lady’s club in a self-breast exam. The nurse is aware that most malignant breast masses occur in the Tail of Spence.
On the diagram below, select where the Tail of Spence is.
Correct Answer: A.
The Tail of Spence is located in the upper outer quadrant of the breast.
500
A client with clotting disorder has an order to continue lovenox (Enoxaparin) injections after discharge. The nurse should teach the client that lovenox injections should:
- A. Be injected into the deltoid muscle
- B. Be injected into the abdomen
- C. Aspirate after the injection
- D. Clear the air from the syringe before injections
Correct Answer: B. Be injected into the abdomen
500
The physician has ordered a histoplasmosis test for the elderly client. The nurse is aware that histoplasmosis is transmitted to humans by:
- A. Cats
- B. Dogs
- C. Turtles
- D. Birds
Correct Answer: D. Birds
Histoplasmosis is a fungus carried by birds
500
Which of the following positions would best aid breathing for a patient with acute pulmonary edema?
- A. Lying flat in bed
- B. Left side-lying position
- C. High Fowler’s position
- D. Semi-Fowler’s position
Correct Answer: C. High Fowler’s position
High Fowler’s position facilitates breathing by reducing venous return. Lying flat and side-lying positions worsen breathing and increase the heart’s workload.
500
A 20-year-old patient is being treated for pneumonia. He has a persistent cough and complains of severe pain on coughing. What could you tell him to help him reduce his discomfort?
- A. "Hold your cough as much as possible."
- B. "Place the head of your bed flat to help with coughing."
- C. "Restrict fluids to help decrease the amount of sputum."
- D. "Splint your chest wall with a pillow for comfort."
Correct Answer: D. “Splint your chest wall with a pillow for comfort.”
Showing this patient how to splint his chest wall will help decrease discomfort when coughing.